Full text of "The Children's Hospital Medical Center Annual Report, 1977"

The 

Children's 

Hospital 

Medical 

Center 

Boston 

1977 




Perspective: 



Today, The Chil- 
dren's Hospital 
Medical Center is a 
complex, high- 
technology institu- 
tion in a complex, 
high-technology 
world. But at its 
heart, there is a 
garden. 



Letter from the 
Chairman 




The year 1977 was one of major movement. 
There was both a change in leadership and an 
overhaul of the organizational structure. 

Dr. Leonard W. Cronkhite, Jr., President since 
1962, resigned March 11, 1977 to assume the 
presidency of the Medical College of Wisconsin. 
Newer members of our professional staff and 
trustee body are probably only partially aware of 
Dr. Cronkhite's contributions to Children's, which 
would require literally pages to adequately cata- 
logue and describe. Perhaps his most visible 
achievement was the comprehensive program 
of new construction and major renovations 
which provided a physical rebirth to our hospital. 
However, he should equally be remembered for 
his concern for the medically underprivileged 
and his creative efforts to better serve this popu- 
lation. His final contribution was the concep- 
tualization, structuring and implementation of 
the joint venture in nursing education with Curry 
College - a project that took literally years in time, 
patience and persuasion to bring into being. 

With the resignation of Dr. Cronkhite, an ad 
hoc committee was appointed to search for a 
dynamic and skillful executive who would serve 
as President and provide the necessary leader- 
ship for the myriad activities of The Children's 
Hospital Medical Center. There has probably 
never been a more abbreviated quest, since 
individually and collectively, the committee 
believed that these qualities were at hand in the 
person of David S. Weiner. These feelings were 
reciprocated by the medical staff and the Dean 
of Harvard Medical School. Accordingly, after the 
shortest kind of "decent interval," David S. Weiner, 
who had served for four years as Executive Vice 
President and immediately before that as Direc- 
tor, was elected as Dr. Cronkhite's successor. 

In the relatively short time since his appoint- 
ment, Mr. Weiner has assembled an extremely 
strong administrative team, and there is steady 
progress and high morale throughout the 
organization. 

For some time it had become increasingly 
evident that time, age, size and other factors had 
rendered cumbersome and obsolete the cor- 
porate structure of the Medical Center. Accord- 



ingly, in late spring the trustees announced plans 
for a comprehensive study of the Medical Cen- 
ter's organizational structure in order to develop 
a new "apparatus" designed to meet the needs 
of the future. The study focused on three major 
areas: (1) role, responsibilities and structure of 
the Board of Trustees and Members of the Cor- 
poration; (2) organizational structure of adminis- 
tration; (3) relationships between administration, 
the Board of Trustees and the medical staff. 

There were periodic progress reports to the 
Trustees' Executive Committee, and preliminary 
recommendations and bylaws were presented to 
the whole Board of Trustees on October 24, 1977. 
Finally, at the annual meeting in December, the 
trustees voted the major reorganization which 
they believe will best meet the policy-making and 
oversight needs of Children's Hospital Medical 
Center, and will allow for more efficient and effec- 
tive performance of board responsibilities. 

In particular, the plan approved: 

> The merger of the Board of Trustees and 
Members of the Corporation into a unified Board 
of Trustees. 

> The creation of a Board of Managers who will 
serve as the policy-making body responsible for 
the general supervision of the hospital. 

> A limited number of functional standing 
committees. 

> The plan clearly charged administration with 
the management of the day-to-day operations of 
the Medical Center and the medical staff with 
providing the clinical expertise required by the 
Medical Center's programs. The President, as 
Chief Executive Officer, is to serve as the main 
link between the Board of Managers, the medical 
staff and the operating organization. 

Our "industry" and our institution will never be 
without problems. However, I can say confidently 
that we are aware of them, and that the basic 
strengths of the institution and its planning mo- 
mentum for the future have never been greater 
than they are today. 



William W. Wolbach 
Chairman 




Letter from the 
President 




I would like to begin this Children's Hospital 
annual report, my first as President, by saying 
how pleased and honored I am to be serving in 
this leadership role. It is especially meaningful for 
me to have succeeded Dr. Leonard Cronkhite, 
who has meant so very much to Children's and 
to me personally. 

Having been part of the hospital family for 
several years, it is with understandable pride that 
1 express my belief that Children's represents 
the very best- a tradition of excellence in child 
health care, teaching and research. Recognition 
of this imposes an added responsibility on 
today's and tomorrow's Children's Hospital lead- 
ers to maintain and strengthen this tradition and, 
at the same time, to respond to increasing exter- 
nal challenges and demands. 

The past three decades have witnessed dra- 
matic changes in the way in which medicine is 
practiced and health care is delivered. There 
have been tremendous advances in medical 
technology, development of alternative methods 
for health care delivery, changes in mechanisms 
for financing care, and increased government 
regulation. The precise impact of these and 
future changes defies measurement; however, 
several trends are clear. 

Recent advances in medical technology have 
made it possible to perform open heart surgery, 
transplant organs, implant artificial devices such 
as pacemakers, and perform surgery on a 
microscopic basis. Mew medicines and drugs 
have reduced the incidence of some diseases 
and shortened the treatment time of others. 
Increasing diagnostic capabilities in areas such 
as nuclear medicine, scanning and ultrasound 
have led to earlier detection and treatment of 
many problems. The computer and other elec- 
tronic devices have made possible the auto- 
mation of functions like patient monitoring, 
laboratory analysis, materials handling and infor- 
mation processing. 

These innovations have several important 
implications for the medical care system and for 
Children's Hospital. They are changing the 
nature of diseases being treated, society's expec- 
tations of what is possible, and the cost of facili- 



ties, equipment and specialized personnel. All in 
all, they are forcing the cost of quality medical 
care higher and higher. 

Because of this, government concern has now 
shifted from a sense that there can never be 
enough to a fear that the present abundance of 
hospital resources is causing wasteful duplica- 
tion of services. Emphasis is turning from acute 
care to preventive care and health maintenance. 
The major focus of thinking in the federal gov- 
ernment and in many states, including Mas- 
sachusetts, is no longer how to enhance hospital 
resources but how to limit them or at least con- 
solidate their diverse components into a more 
economical and efficient system. 

This puts an especially heavy burden on an 
intensely specialized medical center such as 
Children's, for we assume responsibility for the 
most difficult patient care problems and at the 
same time remain committed to education and 
research. The unique costs associated with a 
tertiary care center like ours will be under 
increasing scrutiny; it will become imperative to 
substantiate our costs to third party payors, rate 
setting commissions and other governmental 
agencies. 

Any discussion of health care costs must also 
consider major adjustments in the length of 
hospital stays due to technological and treat- 
ment advances. At CHMC, for example, we have 
seen since late 1975 a significant and highly 
gratifying decrease of over 30 percent in the 
average length of stay of newborns in our Neo- 
natal Intensive Care Gnit. This is clear evidence 
that new and better ways of managing the care 
of these infants have made it possible for us to 
send them home to their parents sooner. 

Equally dramatic are the effects of new surgi- 
cal and casting techniques in the treatment of 
scoliosis (lateral curvature of the spine), which 
have sharply reduced the average length of stay 
for postoperative patients from 30 days to about 
two weeks. Medical progress of this kind is 
expensive, but when the result is a markedly 
improved outcome for patients, the costs are 
justifiable. 

It is clear that we have reached a point where 3 




our future perspectives in health care delivery 
and financing are circumscribed by our ability to 
come to grips with the problem of rising costs. 
I believe it is incumbent upon the health care 
industry itself to suggest rational permanent con- 
trols on rising costs -controls which are effec- 
tive, yet flexible enough that hospitals such as 
Children's can continue to offer a broad spec- 
trum of diagnostic and treatment services. 

Further, we must acknowledge that with the 
advent of Certificate of Meed legislation in Mas- 
sachusetts, the pace of new hospital construc- 
tion will be considerably less rapid than in 
previous decades. The fact that CHMC facilities 
are for the most part exceptionally good is a 
tribute to the foresight of Mr. Wolbach and Dr. 
Cronkhite and to the cooperative efforts of the 
trustees, medical staff and administration. We 
are currently planning a two-story multidisci- 
plinary Intensive Care Unit for which we recently 
received Certificate of Need approval. We are 
also looking toward the relocation and construc- 
tion of a new dental unit, a radiation therapy 
facility and, eventually, a replacement inpatient 
facility on the site of the present power plant. 

Important staff changes at CHMC during the 
past year, in addition to Dr. Cronkhite's resigna- 
tion as President, included the appointment of 
our Psychiatrist-in-Chief, Dr. Julius B. Richmond, 
as Assistant Secretary for Health and Surgeon- 
General of the United States. Joining us during 
1977 were Dr. J. Anthony Hargreaves as Chief of 
Dentistry and Dr. Alan B. Retik as Chief of the 
Division of Urology in the Department of Surgery. 

On the administration side, I have tried since 
becoming President to assemble at Children's a 
team with the high level of expertise to manage 
an extremely complex institution. I am pleased 
to note here that Robert R. Fanning, Jr., was 
appointed Executive Vice President in Sep- 
tember, 1977, and has assumed responsibility for 
operational aspects of the hospital. Henry F Colt, 
Jr., and James J. Fleming also came to Chil- 
dren's during 1977, Mr. Colt as Vice President for 
Development and Mr. Fleming as Director of 
Personnel. In addition, Joseph A. Gagnon was 
recently appointed Director of Fiscal Services. I 



am happy to welcome these physicians and 
administrators to Children's and excited by the 
prospect of working with them and all our staff in 
shaping present and future directions of the 
hospital. 

For the coming year, there is one goal out of 
the many to which the hospital is committed that 
should have long-term implications— that is, our 
increasing focus on the needs of the adolescent 
and young adult population using our services. 
Our adolescents have distinct health and psy- 
chological needs which differentiate their care 
requirements from those of early childhood and 
adulthood. 

Partly because of the rising survival rate for 
children with serious medical problems and 
partly because of new treatment techniques, 
the percentage of CHMC inpatients between the 
ages of 12 and 21 rose from 14 percent in 1968 
to 35 percent in 1976. We have also cultivated a 
major adolescent and young adult population 
through our sports medicine and gynecology 
clinics. It is important for us to modify some of 
our physical environment in keeping with ado- 
lescent and young adult needs and preferences, 
and to offer and communicate to the public the 
kinds of programs that make apparent the hos- 
pital's commitment to adolescents and young 
adults. 

1 look to the future of Children's Hospital with 
optimism. I am confident of our ability to meet 
the challenges ahead and to strengthen and 
enhance the stature of this institution as a 
unique, comprehensive medical center for chil- 
dren and young adults. It is most gratifying to be 
surrounded by so many talented and dedicated 
people who serve Children's Hospital and who 
embody the CHMC tradition. I feel privileged to 
be part of this great tradition. 




David S. Weiner 
President 




The number of adoles- 
cents treated at Chil- 
dren's has increased 
dramatically: from 14 
percent of all inpatients 
in 1968 to 35 percent in 
1976. The hospital has 
responded by planning 
and developing pro- 
grams geared to the spe- 
cial needs of teenagers 
and young adults. 



Letter from the 
Physician-in-Chief 




I would like to share with you the sense of excite- 
ment and challenge that is evident the moment 
you walk through the doors of The Children's 
Hospital Medical Center. The hospital is a large, 
bustling, high-technology institution -but to the 
surprise and delight of many visitors, it is built 
around one of Boston's most beautiful gardens. 

Children are everywhere, and everywhere you 
see an environment dedicated to their emotional 
as well as medical needs. Whenever possible, 
the children are out of bed - in the garden, the 
playrooms, the spacious lobby or the cafeteria. 
Some of the children push their own intravenous 
poles ahead of them; others are in wheelchairs 
or even stretchers; some are wearing football 
helmets to protect their recently operated heads 
from injury. 

The children are rarely alone. Striking is the 
number of adults per patient, from nurses and 
students of all sorts to parents, friends and pink- 
jacketed volunteers. 

Approximately 300 babies, children and 
young adults are inpatients at any one time, and 
400-500 are seen daily as outpatients in the 
clinics and emergency room. Their needs are 
met by the more than 3,000 employees of this 
complex world within a world. 

Medical Care The medical staff includes gen- 
eralists and specialists, some of whom are full- 
time, some part-time, and others in practice in 
the community. With the recent explosion in 
scientific knowledge has come a tendency to 
ever greater specialization, as highly complex 
laboratory and clinical skills require more and 
more concentrated experience. 

For example, bone marrow transplantation, 
by which we have recently scored lifesaving 
triumphs over some rare disorders, requires a 
complex network of many individuals. This 
teamwork— found in institutions such as ours- 
illustrates the interdependence of specialists 
who together produce a quality of medical care 
never before attainable. 

But today's pediatrics is concerned not only 
with major surgical operations or intensive care. 
Teamwork of another variety takes place in the 
child development programs in the Fegan Build- 



ing and in the Adolescents' Unit. Here, represen- 
tatives of many disciplines work together to help 
children with a wide variety of dysfunctions which 
may impose severe handicaps but not require 
hospitalization. We are increasingly involved with 
preventive pediatrics, such as early identification 
of potentially threatening conditions and mobili- 
zation of medical and community resources, to 
help foster strengths and overcome, correct or 
bypass weaknesses. 

Our settings for patient care, while concen- 
trated at the hospital itself, are not exclusively 
here. In recent years we have assumed increas- 
ing responsibility for pediatric care in neigh- 
borhood health centers and at the Wrentham 
State School. We have close ties to a number of 
school health programs, and are participants in 
the Brookline Early Education Project with indi- 
viduals in the Harvard School of Education. The 
new Lahey Clinic primary care center in Burling- 
ton is affiliated with this institution. Members of 
our staff are consultants to a large number of 
other hospitals, medical schools and to state and 
national health agencies. 

Regionalization Children's Hospital serves as a 
regional center for coordination of many child 
health activities. The Mew England Regional 
Infant Cardiac Program guided by Dr. Alexander 
S. Nadas, Chief of Cardiology, is concerned with 
diagnosis of malformations of the heart and 
referral to appropriate centers for repair. Simi- 
larly, the Massachusetts Poison Control System 
has its headquarters at CHMC. Our renal dialysis 
program serves regional needs, and we have 
pioneered in kidney transplantation in children. 

This institution has long been associated with 
advances in the understanding and care of chil- 
dren with cystic fibrosis. Dr. Harry Shwachman 
was honored last year by the International Cystic 
Fibrosis Foundation for these efforts. Now 
retired as director of the program, he continues 
to teach and see patients. Dr. Harvey R. Colten, a 
student of allergy, immunology and infectious 
diseases, is his successor as program director 
and has launched major studies on mechanisms 
of resistance to pulmonary infections. 

Other areas of special emphasis which bring 




Twenty-five years ago, 
critically ill newborns 
had little hope of survi- 
val. Dramatic medical 
and technological 
advances since then 
have cut the mortality 
rate for these babies in 
half. Children's in Boston 
provides the finest inten- 
sive care for infants that 
is available today. 




./^ M ^ \ ' 



' **»*^ 





patients from near and far include correction of 
curvature of the spine. Studies on immune 
deficiency states, a long-standing interest of 
Dr. Charles A. Janeway, are continuing under 
Dr. Fred S. Rosen and colleagues. Mew insights 
into cellular and humoral aspects of immunity 
have resulted in identification of several disease 
processes over recent years. 

Area Cooperation Collaboration with institu- 
tions in our immediate geographical area is 
another important effort at CHMC. In fact, our 
hospital is at the hub of a group of illustrious 
medical institutions -Harvard Medical School, 
Harvard School of Public Health, Countway Med- 
ical Library, Boston Hospital for Women, Beth 
Israel Hospital, New England Deaconess Hospi- 
tal, Joslin Clinic and our closest neighbors, the 
Peter Bent Brigham Hospital, the Sidney Farber 
Cancer Institute and the Dana Cancer Center. 
Good neighbors bring wide-ranging consultative 
services, permit joint programs that can be 
more effective than competing ones, and allow 
trainees of all levels to bring us new ideas and 
questions, just as we provide education on the 
special needs of children. 

Our ties with area neighbors, like those with 
pediatricians at the Massachusetts General Hos- 
pital, increase as we respond to possibilities for 
sharing resources, containing costs and improv- 
ing our capacity to provide optimal patient care 
while enlarging educational opportunities. 

For example, our Joint Program in Neo- 
natology, under the direction of Dr. H. William 
Taeusch, Jr., and his colleagues, serves the 
needs of over 8,000 infants born at the Boston 
Hospital for Women and Beth Israel Hospital, as 
well as nearly 350 per year referred to Children's 
Hospital from more distant sites. Close collabo- 
ration with other neonatal units in Boston and 
environs assures all infants who require intensive 
care of its continuous availability. 

Radiation therapy and computerized tomo- 
graphy shared with area institutions illustrate a 
desire to reduce duplication of expensive re- 
sources. At the same time, we think it imperative 
that our small patients (and sometimes larger 
ones as well) have ready access to services 



designed to meet their particular needs. 

In an age of specialization, joint training pro- 
grams and conferences with internists in infec- 
tious diseases, cardiology, endocrinology, 
gastroenterology, dermatology, the surgical spe- 
cialties and dentistry permit investigators to think 
beyond the age usually identified with pediatrics 
and encourage trainees to study the natural 
course of illness, including the childhood precur- 
sors of adult problems. 

Research The Clinical Research Center is the 
major setting for clinical investigation at Chil- 
dren's Hospital. Supported by the National Insti- 
tutes of Health, the center is now in its 15th 
consecutive year of operation. New ideas and 
approaches to clinical problems are applied 
here, under the scrutiny of senior investigators 
and monitored by the hospital Committee on 
Clinical Investigation. All clinical research at Chil- 
dren's is carefully reviewed and conducted only 
with informed consent of patients when possible, 
or parents and patient advocates in the case 
of infants. 

The major focus of biomedical research is in 
the John Enders Laboratories for Pediatric 
Research and the laboratories of the Sidney 
Farber Cancer Institute. Our major attack on 
childhood malignancies is under the leadership 
of Dr. David G. Nathan, who serves as Pediatri- 
cian-in-Chief for the Sidney Farber Cancer Insti- 
tute and Hematologist-in-Chief for Children's 
Hospital. Progress in treatment of cancer in chil- 
dren is continuous, with each year bringing an 
ever increasing number of long-term survivors. 
The many recent advances in hematology 
include prenatal diagnosis of sickle cell disease 
and thalassemia, removal of excessive body 
stores of iron by continuous infusion of iron 
chelating agents, and insights into the basic 
defect in hypoplastic anemias. 

The group in genetics under Dr. Park S. Gerald 
has continued basic studies on gene mapping, 
as they search for understanding of normal 
development and congenital malformations. 
This past year, Dr. Samuel A. Latt has opened a 
new chromosome laboratory at the Boston Hos- 
pital for Women to permit application of his tech- 





The Enders Laboratories 
for Pediatric Research at 
Children's make up the 
largest pediatric research 
facility in the world. Here, 
basic scientists and phy- 
sician-investigators 
search for solutions to 
the problems of pediatric 
disease and for answers 
to the puzzle of human 
development. 




10 



niques for the identification of chromosomes 
to aid prenatal diagnosis and pursue studies on 
the causes of birth defects. 

A major new program in experimental pathol- 
ogy has been initiated by Dr. Lynne Reid, S. Burt 
Wolbach Professor of Pathology. Dr. Reid, who 
came from the Brompton Hospital in London, 
brought her team of investigators from England 
to pursue studies in pulmonary pathology. She 
and her group are examining alterations in the 
lung found in association with congenital heart 
disease, cystic fibrosis, hyaline membrane dis- 
ease and the sudden infant death syndrome. 

Aspects of brain development, causes of injury 
in premature infants, and impact of infections on 
the nervous system are topics of study by neurol- 
ogists, neuropathologists and students of infec- 
tious diseases, whose goal is the prevention of 
birth defects, mental retardation and central ner- 
vous system injury. 

Education How are all these new ideas com- 
municated? Surely a complete view of the pro- 
fessional activities of Children's Hospital requires 
a moment to focus on the educational activities 
undertaken by the staff. 

The several hundred research publications 
each year, and the four or five textbooks written 
annually by staff reach a worldwide audience. 
Continuing medical education, now mandated 
for license renewal, has greatly increased interest 
in weekly teaching conferences. We sponsor 
about ten postgraduate courses each year, which 
attract more than one thousand registrants from 
this country and abroad. 

As a Harvard teaching hospital, we have resi- 
dency training programs in all pediatric and 
pediatric surgical specialties. Interns and resi- 
dents from other hospitals, medical and dental 
schools rotate through our clinics for further 
training. About sixty third- and fourth-year Har- 
vard Medical School students come in groups of 
8-12 to work on our clinical teams and learn 
pediatrics. Others come on elective rotations in 
many specialty areas. Student nurses from our 
affiliated Curry College Program and other stu- 
dents from neighboring Simmons and North- 
eastern colleges rotate through the special 



clinics of Children's Hospital. 

Educational enterprises are so closely inter- 
woven with the other missions of the hospital 
that future planning will surely require definition 
and identification of more suitable classrooms 
and support facilities for this important activity. 
We are a larger "college" than some colleges, 
even as we try to fulfill our central mission of 
providing optimal care for children. The pres- 
ence of questioning students is a significant 
factor in insuring that care, just as educational 
activities insure the presence of skilled care- 
takers for the future. 

I have only touched upon the basic goals and 
programs of the enterprise known as The Chil- 
dren's Hospital Medical Center. A full description 
would have to mention many other services: the 
burgeoning dental clinic under its new Chief, 
Dr. J. Anthony Hargreaves; ambulatory surgery 
where ever increasing numbers of children are 
treated without the added stress of hospitaliza- 
tion; the diagnostic test center; and the busy 
emergency room (a euphemism for a 24-hour 
drop-in clinic). This last setting not only serves 
the needs of our neighbors, but is also a 
resource for practicing physicians. 

Another important service, the Comprehen- 
sive Child Health Program, has now enrolled 
over 7,000 children. Previously the recipients of 
episodic care, these children now receive contin- 
uing primary care. This clinic within the hospital 
is the focus for studies on aspects of health care 
delivery, such as the development of telephone 
protocols for use by paramedical personnel. 

This brief description of Children's Hospital 
Medical Center has been a "tour" of sorts -one 
in words. We invite you to come and tour the 
hospital in person, so that you can share our 
enthusiasm for the great heritage, as well as 
potential, of this institution. 



/CuOu^jifeUZ 



Mary Ellen Avery, M.D. 
Physician-in-Chief 




/ 




Focus: 



The surgical 
advances made at 
Children's Hospital 
over the past dec- 
ade continue a tra- 
dition of innovation 
that reaches back 
to the very begin- 
nings of pediatric 
surgery. 



11 



Pediatric surgery is very 
different from adult sur- 
gery. In children, opera- 
tions must be scheduled 
so they don't interfere 
with future growth and 
maturation. Pediatric sur- 
geons must also con- 
sider the psychological 
and social effects of sur- 
gery on a developing 
child. 



12 




There's a small portable pump on Tommy's bed- 
side table. At night, his mother connects it to a 
tiny rubber tube implanted in her son's stomach. 
While Tommy sleeps, the pump does what his 
body cannot do for itself: It supplies glucose 
to his blood stream at a controlled, steady rate. 
Without the glucose, Tommy would go into con- 
vulsions. Without the glucose, he would prob- 
ably be retarded by now. Without the glucose, 
he would have little hope of surviving beyond 
his fifth birthday. 

Carol was bom with Crouzon's syndrome, a 
massive and cruel disfigurement of the face. Her 
cheeks were sunken, her eyes protruded, and her 
lower lip stuck out because of an overbite of the 
lower jaw. Then, when she was 14 years old, a 
team of surgeons cut the entire midface (from 
the lower forehead to the chin) from the base of 
the skull and moved it forward VA inches. Both 
jaws and orbits around the eyes had to be rotated 
individually to obtain symmetry of the facial 
structures. The operation took 12 hours and was 
followed by several months of recovery. But it 
has changed Carol's whole appearance and her 
outlook on herself and her life. 

The diagnosis was obvious the moment 
Joseph was born. His intestines were outside the 
abdominal cavity— a condition known as ompha- 
locele. In an operation carried out the day he was 
born, surgeons covered the abdominal wall with 
two layers of plastic, one a Teflon mesh and the 
other a sheet of fine polyethylene. As space 
developed within Joseph's abdomen, the plastic 
layers were gradually removed and the intestines 
returned to the abdominal cavity. Within ten days, 
all the plastic was gone and the abdominal wall 
completely corrected with normal musculature 
and skin. Had Joseph been born before this 
technique was developed, he probably would 
have died. 

Tommy's treatment and the method for repair- 
ing omphaloceles were developed at the Chil- 
dren's Hospital Medical Center. The operation 
that reconstructed Carol's face was performed for 
the first time in the United States at Children's 
Hospital. These are just three of the dozens of dis- 



coveries and surgical advances made at Children's 
over the past decade, continuing a tradition of 
innovation that reaches back to the very begin- 
nings of pediatric surgery. 

Soon after Children's Hospital opened its 
doors in 1869, it began to build a reputation for 
excellence in orthopaedic surgery: By the end 
of the century, it was an acknowledged leader. 
That expertise became nationally known during 
the polio epidemics that ravaged the Northeast 
in 1916 and then swept the country in 1949 
and 1955. 

During the past half century, surgeons at Chil- 
dren's Hospital have pioneered in the develop- 
ment of procedures to correct a wide variety of 
intestinal abnormalities, in the use of general 
anesthesia for removing foreign bodies from air 
and food passages, and in many other advances. 
The first successful cardiovascular operation for 
congenital heart disease was performed here in 
1938 by Dr. Robert E. Gross. 

"Many of the surgical advances of the past 
decade have been built upon the gains made by 
our predecessors," notes Dr. Judah Folkman, 
Surgeon-in-Chief. Surgical advances from Chil- 
dren's Hospital are widely recognized as among 
the most significant in the world. 

In 1975, the American College of Surgeons 
and the American Surgical Association published 
a Summary Report of the Study on Surgical 
Services for the Gnited States which identified 
the most important contributions of surgical re- 
search to health care from 1945 to 1970. 

Contributions were listed by specialty, accord- 
ing to the first, second and third order of impor- 
tance. The three most important developments 
in pediatric surgery during that time took place 
atCHMC. 

First in order of importance came the com- 
bined drug and surgical therapy for Wilms' 
tumor, the result of collaborative work by CHMC's 
Dr. Sidney Farber and Dr. Robert E. Gross. Sec- 
ond was the treatment for Hirschsprung's disease 
developed by Dr. Orvar Swenson while at Chil- 
dren's. Two procedures shared the spotlight for 
third order of importance: One of them was the 
technique for repair of omphaloceles developed 




13 




14 



by Dr. Samuel R. Schuster, Associate Chief of 
Surgery at CHMC 

In 1966, surgeons at Children's Hospital per- 
formed the first one-stage midface advancement 
operation for Crouzon's syndrome in the United 
States. Since that time, over 250 other children 
with severe facial defects have been successfully 
operated on. These include most congenital 
problems, but also deformities secondary to the 
treatment of cancer and those following acciden- 
tal injuries. The surgical team -led by Dr. Joseph 
E. Murray with his associates, Drs. John B. Mulli- 
ken and Leonard B. Kaban, of Oral Surgery - 
today treats a wide variety of problems in con- 
junction with the Neurosurgical and Ophthal- 
mological services. 

The kidney transplant program at CHMC was 
started in 1971 by Dr. Raphael H. Levey. Soon 
afterward, a program in the total care of children 
with end-stage renal disease was developed. 
Today it is one of the two largest pediatric trans- 
plantation and dialysis programs in the world, as 
well as the major referral center for children from 
the New England Region. 

Dr. Levey and his associates have developed 
new technology which makes hemodialysis in 
extremely small children possible, by providing 
access to the patient's tiny arteries and veins. 
These techniques have been applied to the care 
of many children with tumors who require pro- 
longed anti-cancer drug therapy. 

The surgical laboratory prepares a potent 
immunosuppressive agent, which has markedly 
improved the acceptance of kidney transplants 
and also helped in the care of patients on the 
medical service who are scheduled to receive 
bone marrow transplantations. 

Before 1973, infants born with critical heart 
defects usually faced two major operations. The 
first, performed within the first year of life on the 
closed heart, reduced the effects of the defect on 
the body. The second, an open-heart operation 
done when the child reached three to five years, 
totally corrected the problem. 

Since 1973, a dramatic technique of cooling 
the body to a point of suspended animation has 
enabled surgeons at CHMC to completely correct 



operable defects in a single operation within the 
first year of life. "This technique, combined with 
advances in diagnosis and postoperative care, 
made the risk of early one-step correction sig- 
nificantly less than that of two operations," says 
Chief of Cardiovascular Surgery, Dr. Aldo 
R. Castaneda, who introduced the new proce- 
dure here. 

In addition, early total correction means that 
the child can develop normally, without the 
psychological and social problems that some- 
times go along with serious physical disabilities. 
Since 1973, 300 babies have successfully under- 
gone this one-step operation— the smallest 
weighed two pounds, the youngest was 38 
hours old. 

Dr. Folkman's special interest in the problems 
posed by glycogen storage disease goes back 
more than a decade. 

His first contribution, in collaboration with Dr. 
John F Crigler, was the development of a new 
technique that substantially reduced the risk of 
mortality, while maintaining the benefits of the 
previous procedure. 

This led to a further improvement in which a 
tiny tube is permanently implanted into the stom- 
ach, so that glucose can be infused continu- 
ously at night by a mini-pump. The need for 
major surgery has been eliminated, and these 
children are now growing into normal, healthy 
youngsters. 

A group of otolaryngologists (ear, nose and 
throat specialists) who pioneered the use of laser 
beams in the larynx have been refining and 
expanding that technique at CHMC for the past 
two years. 

Traditionally, children who develop large 
growths inside the breathing passages often re- 
quire tracheotomies (tubes surgically implanted 
in the trachea through the neck) in order to 
breathe. The growth itself is removed by forceps 
through the mouth or by surgically entering 
through the skin. 

With a laser, the surgeon directs an invisible 
beam of light down a tube, using an intricate sys- 
tem of mirrors and a powerful operating micro- 
scope. The beam can act as a scalpel, cutting 




In pediatric surgery, cor- 
recting a defect in a 
month-old infant 
demands the utmost in 
surgical precision. It also 
requires the skills of the 
finest radiologists and 
anesthesiologists, the 
support of the best nurs- 
ing and residency staffs, 
and the expertise of 
many other specialists. 



15 




16 



away growths, or it can destroy the harmful tis- 
sue by vaporizing it. There is no bleeding 
(because the beam coagulates the vessels before 
they have a chance to bleed), little swelling and 
little or no scar tissue formation. 

Children come to CHMC from all over the 
world for treatment of all types of spinal problems. 
Many of these children have severe deformities 
which have been unsuccessfully dealt with else- 
where. Surgical management, involving opera- 
tions on both the front and back of the spine, 
may be needed. Many problems require several 
staged operations to achieve success. 

CHMC is one of the few centers in the world that 
can provide the combination of expertise needed 
to treat the entire range of spinal curves, from the 
simplest to the most severe. 

The hospital team, led by Dr. John E. Hall, 
Chief of Clinical Services in Orthopaedic Surgery, 
offers a range of methods for treating spinal 
curvatures. The Boston Brace System, developed 
here four years ago, combined with physical 
therapy, controls the problem in most children, if 
it is detected early enough. Severe curvatures, 
however, require surgery in which the spine is 
straightened with mechanical devices and the 
affected vertebrae are fused together with bone 
grafts. Each year the Children's team sees 
between 400 and 500 patients for brace treat- 
ment and performs about 350 spinal operations. 

Some of the most exacting and delicate surgi- 
cal techniques are required to remove cataracts 
from children's eyes. Ophthalmologists, under 
department Chief Dr. Richard M. Robb, use a 
ceiling-mounted microscope to magnify the 
operating field up to 20 times. A tiny incision is 
made at the edge of the cornea, and a blunt 
needle introduced through it into the lens cap- 
sule. A special syringe attached to the needle then 
draws out the cataractous material. This intricate 
technique is a dramatic improvement over the 
method used just ten years ago which required a 
much larger incision, sometimes repeated surgi- 
cal openings and a longer healing period. 

This is only a partial list of the important 
surgical achievements made at Children's in the 
past decade. They represent attempts to under- 



stand and treat some of the most complex and 
serious childhood illnesses. 

The success of any surgery -from the most 
routine procedure to a historic first-time opera- 
tion - depends upon a network of supporting 
services. "Some of our procedures simply 
couldn't be done without an accurate diagnosis 
through radiology and clinical testing. When an 
operation is modified or designed specifically to 
meet special needs of a particular patient, com- 
plete and accurate diagnostic information is vital 
to success," explains Dr. Folkman. The radiology 
services at Children's are "superb," he says, not 
only in the sophistication of their techniques, but 
also in the accuracy of interpretation. 

In the operating room itself, surgeons rely on 
anesthesiologists to stabilize patients during the 
trauma of surgery. "Administering the anesthesia 
and then monitoring the patient's vital signs are 
much more complicated in children than in 
adults," points out Dr. Folkman. 

Excellent care after the operation -particularly 
during the first crucial hours and days -is as 
important as excellent surgery. Physical and respi- 
ratory therapists, nutritionists and many other 
specialists provide that care. But the pivotal figure 
is the nurse, and nurses at Children's are, very 
simply, the best, according to Dr. Folkman. 

The training of new pediatric surgeons and 
continuing education for those already in practice 
are important aspects of the surgical services at 
CHMC. The residency training program is among 
the most rigorous and intensive in the country. 
CHMC graduates go on to top positions in hospi- 
tals around the world. In the United States and 
Canada, the chiefs of surgery at 12 of the 16 
children's hospitals certified to train pediatric 
surgeons were themselves trained at CHMC. 

"Professional education -of physicians, nurses 
and other specialists- is an integral part of the 
day-to-day life of this institution," says Dr. Folk- 
man. It is also vital to the hospital's long-range 
mission, for it insures that the medical achieve- 
ments made at CHMC and the expertise devel- 
oped here will be available to children through- 
out the country and the world - and to children 
of the future. 




Report: 



Statistical and 
financial data for 
the year 1977: sta- 
tistics on patient 
care, hospital per- 
sonnel, Report of 
the Treasurer, 
income statement, 
and statement of 
fund balance. 



17 



Statistics - 1 977 The Children's Hospital Medical Center is the hospital for children, it is now a comprehensive 

largest and second oldest pediatric hospital in center for child health care offering a full range 

the United States. Founded in 1869 as a 20-bed of medical and surgical services. 

Patient 

Number of licensed beds 343 

Inpatients served 1 3,056 

Patient days 98,660 

Average stay 6.9 days 

Clinic visits 1 14,357 

Number of clinics 92 

Emergency room visits 60,071 

Surgical Procedures 

Inpatient 6,754 

Outpatient 2,733 

Total 9,487 

Radiology 

Patient visits 65,698 

Procedures performed 75,360 

Laboratory tests 495,985 

Personnel 

Medical sta 
Dental stafi 

Associated scientific staff 1 75 

Courtesy staff 173 

House staff and Fellows 348 

Nursing staff 591 

Other full-time employees 1 ,809 

Part-time employees 578 

Volunteers 663 



18 



Report of the 
Treasurer 



The following financial statements, audited by 
Peat, Marwick, Mitchell & Co., constitute the 
Report of the Treasurer for The Children's 
Hospital Medical Center's fiscal year ended 
September 30, 1977. 

The statements reflect the achievement of the 
important interim objective of a "break-even" 
from operations after depreciation, utilizing 
investment income. I'm advised that this was 
accomplished without detriment to patient care 
activities at the hospital. Moreover, due to the fine 
efforts of the Investment Committee, the Chil- 
dren's Hospital portfolio has outperformed the 
standard indices of investment performance in 
the fiscal year just ended while increasing 
income per unit Even without investment 
income, 1977 operating results were approxi- 
mately $350,000 better than those of 1976, after 
fiscal 1976 had shown an improvement of more 
than $1,050,000 relative to 1975. Credit is due to 
management and the entire community of The 
Children's Hospital Medical Center for these 
results. Among its other pluses, this financial 
milestone is an encouraging step toward assur- 
ing the future fiscal strength of the Medical 
Center. 

However, this is no time for complacency. 
For example, as is true for virtually all hospitals, 
historical depreciation allowances are inade- 
quate because of inflation, technological 
advances, and increasingly stringent regulatory 
and licensure requirements. Progress was made 
in 1977, but much work still lies ahead. 



With the continuation of the kind of effort 
which everybody involved exerted in the year just 
ended, and barring external factors beyond the 
adjustment ability of the institution, the current 
fiscal year can now show further financial 
improvement 

This will be my last report as Treasurer and 1 
would like to take this opportunity to thank the 
medical staff, management, and my fellow offi- 
cers and trustees for their cooperation and help 
over the years. I have considered it an honor and 
a privilege to have served as Treasurer and look 
forward to continuing as Chairman of the Audit 
Committee. 



CtaJL. 



4UMV 



f<£#**/«VUhA^ 



Ephraim Radner 
Treasurer 



19 



Statement of 
Revenues and 
Expenses 



Year Ended September 30, 1977 

Patient service revenue $56,402,979 

Adjustments granted (free care, contractual, etc.) (7,696,799) 

Net patient service revenue 48,706,180 

Other revenue 7,965,797 

Total operating revenue 56,671,977 

Patient care expenses 57,720,042 

Loss from patient care operations (1 ,048,065) 

Loss from research, training, etc (179,460) 

Loss attributable to residential complex (207,487) 

Loss from operations (1,435,012) 

Non-operating revenue 3,603,350 

Balance available for future programs $ 2,168,338 

Note: The above figures are taken from the audited financial statements for year ending September 30, 1977. 



Auditors 

Peat, Marwick, Mitchell & Co. 
Certified Public Accountants 



Condensed 
Balance Sheet 
September 30, 
1977 and 1976 



Assets 19T7 1976 

Unrestricted funds: 

Current 

Cash $ 351,071 $ 574,368 

Accounts receivable, net 13,256,890 13,681,234 

Inventories 475,758 451,934 

Prepaid expenses 142,258 391,614 

Total 14,225,977 15,099,150 

Cash surrender value — deferred compensation 1 ,032,344 943,409 

Investments, at cost 10,551,727 10,750,458 

Property, plant and equipment, at cost less 

accumulated depreciation 48,980,302 47,912,908 

Total 74,790,350 74,705,925 

Restricted funds: 

Accounts receivable 2,340,155 2,942,232 

Investments, at cost 27,043,862 25,566,992 

Total $104,174,367 $103,215,149 

Liabilities and Fund Balances 

Unrestricted funds: 

Current: 

Current portion of long-term debt $ 376,694 $ 349,203 

Accounts payable and accrued expenses 5,613,463 9,511,834 

Due to third party payors 2,673,975 1,609,681 

Deferred revenue 40,876 147,995 

Total 8,705,008 11,618,713 

Long-term debt, excluding current portion 11,871,587 12,251,522 

Deferred compensation 1,032,344 943,409 

Accrued employees' retirement plan expense 1 ,929,432 2,002,927 

Fundbalance 51,251,979 47,889,354 

Total 74,790,350 74,705,925 

Restricted funds: 

Specific purpose funds 8,672,646 8,519,278 

Endowment funds 20,527,003 19,896,046 

Funds held for others 184,368 93,900 

Total $104,174,367 $103,215,149 



21 



In a modern medical 
center like Children's, 
many people work 
behind the scenes: 
administrative personnel, 
dietary workers, pharma- 
cists, skilled tradesmen 
and many others. While 
less visible than doctors 
and nurses, these people 
are also dedicated to 
patient care. 



22 





People: 



There are many 
talented and dedi- 
cated individuals 
who serve and 
embody the CHMC 
tradition, shaping 
the present and 
future directions of 
Children's Hospital 
Medical Center. 



23 



Officers 



William W. Wolbach 

Chairman of the Board 

William N. Swift 

Vice Chairman 

David S. Weiner 

President 

George W. Phillips 

Treasurer 

Mrs. Howard F Gillette 

Secretary 

Miss Antoinette J. Valenza 

Assistant Secretary and 

Assistant Treasurer 



Honorary Life Trustees 

Mrs. Robert G. Fuller 
Mr. Francis H. Gleason 
Miss Amelia Peabody 
Mrs. Roger A Perry 
Miss Margaret A. Revere 
Mrs. David Wilder 



24 



Board of Managers 

William W. Wolbach 

Chairman 

William N. Swift 

Vice Chairman 

David S. Weiner 

President 

Mrs. Howard F Gillette 

Secretary 

George W. Phillips 

Treasurer and Chairman, 

Finance Committee 

Joseph W. Powell, Jr. 

Chairman, Development and 

Public Affairs Committee 

E. James Morton 
Chairman, Compensation and 
Benefits Committee 

F. Gorham Brigham, Jr. 
Chairman, Nominating 
Committee 
DavidAMittell 

Chairman, Building and Real 
Estate Committee 
Ephraim Radner 
Chairman, Audit Committee 
David I. Kosowsky, ScD 
Chairman, Research 
Committee 

Mrs. Lee Day Gillespie 

Chairman, Joint Planning 

Committee 

John A Kirkpatrick, MD 

Chairman, Medical Staff 

Executive Committee 

Mrs. Carlton M. Akins 

Chairman, Women's 

Committee 

E. Lorraine Baugh, RN 

Member-at-large 

Paul F Hellmuth 

Member-at-large 

William F Morton 

Member-at-large 

Ben Ames Williams, Jr. 

Member-at-large 



Chiefs of Service 



Mary Ellen Avery, MD 
Physician-in- Chief 
Judah Folkman, MD 
Surgeon-in-Chief 
Charles F Barlow, MD 
Chief, Department of 
Neurology 

Aldo R. Castaneda, MD 
Chief, Department of 
Cardiovascular Surgery 
Melvin J. Glimcher, MD 
Chief, Department of 
Orthopaedics 
John E. Hall, MD 
Chief, Clinical Orthopaedics 
J. Anthony Hargreaves, LDS, 
MChD 

Chief, Department of Dentistry 
Samuel Hellman, MD 
Chief, Department of Radia- 
tion Therapy 
John A Kirkpatrick, MD 
Chief, Department of 
Radiology 

Alexander S. Nadas, MD 
Chief, Department of 
Cardiology 
Lynne Reid, MD 
Chief, Department of 
Pathology 
Richard M. Robb, MD 
Chief, Department of 
Ophthalmology 
Donald J. Scherl, MD 
Acting Chief, Department of 
Psychiatry 
Robert M. Smith, MD 
Chief, Department of 
Anesthesiology 
Stuart M. Strong, MD 
Chief, Department of 
Otolaryngology 
W. Keasley Welch, MD 
Chief, Department of 
Neurosurgery 



Administrative Officers 

David S. Weiner 
President 

Robert R. Fanning, Jr. 
Executive Vice President 
Henry F Colt, Jr. 
Vice President for Develop- 
ment and Public Affairs 
Margery Goldman 
Assistant to the President 
Anne S. Black ,RN 
Director of Nursing Services 
James J. Fleming 
Director of Personnel 
Joseph A Gagnon 
Director of Fiscal Services 
Gail Garinger, JD 
Director, Office of Legal 
Counsel 
Rudman J. Ham 
Director of Planning 
Virginia R. Stuart 
Director of Public Relations 
Ethel Trafton.RN 
Director, School of Nursing 

Oliver Scott 

Anthony J. Aveni WMiveApnii.ws) 

Director of Administrative 

Services 

Thomas M. Botts 

Director of Clinical Services 

Albert L Broseghini, PhD 

Director of Research 

Admin istration 

Kathleen R. Crampton 

Director of Ambulatory 

Services 

C. Grant LaFarge, MD 

Director of Quality Assurance 

Marva Serotkin 

Director of Patient Services 



The Board of Trustees 

(as of March 1,1978) 

Charles F Adams 

Daniel S. Ahearn 

Mrs. Carlton M. Akins 

Mrs. Alvin B. Allen 

George Alpert 

Kent Andrews 

Julian D. Anthony 

Mary Ellen Avery, MD 

Neil R. Ayer 

Mrs. W. Benjamin Bacon 

Sherwood E. Bain 

Nelson S. Bartlett, Jr. 

Mrs. Charles E Batchelder, Jr. 

E. Lorraine Baugh, RN 

Richard A Berenson 

George Berman 

Harold Bernstein 

Gordon E Bloom 

Alexander Brin 

E Gorham Brigham, Jr. 

Francis H. Brooks 

John G. Brooks 

Paul R Brountas 

William L. Brown 

Thomas D. Cabot 

Norman L Cahners 

Mrs. David Casty 

Ephron Catlin, Jr. 

Eugene H. Clapp II 

Mrs. Eugene H. Clapp II 

Logan Clarke, Jr. 

Hon. Richard Comerford 

John L. Cooper 

Sidney Covich 

Mrs. William C. Cox 

James H. Crissman 

Leonard W. Cronkhite, Jr., MD 

George Cuker 

Mrs. Chester C. d'Autremont 

Roger C. Damon 

Mrs. Albert V. Danielsen 

Mrs. Martin J. DeMatteo 

S.S. Dennis III 

Charles Devens, Jr. 

Willard Blake Dik 

Mrs. William R. Driver 

William S. Edgerly 

Joseph A Erickson 

Hans H. Estin 

Albert P. Everts, Jr. 

Paul W. Fager 

Donald Falvey, Jr. 



Stanley H. Feldberg 

Mrs. Robert P. Fitzgerald 

John G. Flint 

Alexander C. Forbes 

E Murray Forbes, Jr. 

Mrs. Edward L. Francis 

George N. Friedlander 

Mrs. Dale Friend 

Charles M. Ganson, Jr. 

George P. Gardner, Jr. 

Harrison Gardner 

John L. Gardner 

William Gibson 

Mrs. Lee Day Gillespie 

Mrs. Howard F. Gillette 

Commissioner George Gilman 

Stanley P. Goldstein 

Mrs. H. Shippen Goodhue 

John W. Goodrich 

Robert G. Gordon 

Mrs. John A Gray 

Roland Gray, Jr. 

Mrs. Arthur R. Greene 

Robert E. Gregg 

Stephen J. Griffin 

Earle Groper 

John L. Hall II 

John M. Hall 

Robert H. Hallowell, Jr. 

Lawrence H. Hansel 

Mrs. Lawrence H. Hansel 

Francis A Harding 

George R. Harding, Jr. 

Francis W. Hatch, Jr. 

Mrs. Leslyn A Hayden, Jr. 

Paul F. Hellmuth 

Mrs. Converse Hill 

Mrs. Albert A Hittel 

Daniel E. Hogan, Jr. 

Amor Hollingsworth 

Charles H. Hood 

HarVey R HOOd (deceased March 3,1978) 

Mrs. Edward B. Hopkins 
Mrs. Robert H. Hopkins 
Mrs. Charles F. Hovey 
Henry S. Howe 
Weston Howland, Jr. 
James F. Hunnewell 
Kenneth L. Isaacs 
James Jackson, Jr. 
Edward C. Johnson III 
David M. Kaplan 
Senator Edward M. Kennedy 
Mrs. Edward M. Kennedy 
John C. Kiley, Jr. 
Mrs. John C. Kiley, Jr. 



Frederick M. Kimball 
John A. Kirkpatrick, MD 
Carleton Knight, Jr. 
David I. Kosowsky, ScD 
Benjamin Kulp 
C. Haven Ladd 
Mrs. John E. Lawrence 
Albert E. Lerman 
Paul Lerman 

Mrs. Norman B. Leventhal 
Mrs. Edward M. Levitt 
Mrs. Stephen Little 
John H. Livens 
Mrs. John H. Livens 
Robert Livermore 
William DeE Manice, Jr. 
Mrs. Julian A Marzynski 
Austin B. Mason 
George J. Matthews 
Joseph C. McNay 
Richard W. Mechem 
Mrs. Douglas Mercer 
Melvin B. Miller 
James J. Minot 
David A. Mittell 
Frank E. Morris 
Hon. Francis X. Morrissey 
Major Nicholas R Morrissey 
E. James Morton 
William E Morton 
Frederick S. Moseley III 
Alexander S. Nadas, MD 
Peter W. Nash 
Mrs. Kirke A. Neal 
Mrs. Arthur H. Nelson 
Charles B. Newhall 
William G. Nickerson 
Robert C. Nordblom 
William A. Oates, Jr. 
Frank O'Brien, Jr. 
J. Warren Olmsted 
Thomas A Pappas 
William A. Parker 
Julian L. Pearlman, MD 
Irving Perlmutter 
Edgar A. Perry 
Mrs. Roger A. Perry, Jr. 
George W Phillips 
Mrs. Richard E Piper 
Robert S. Pirie 
Everett R Pope 
Joseph W Potter, Jr. 
Mrs. Nancy CIpp Potter 
(Mrs. Joseph W. Jr. ) 
Joseph W. Powell, Jr. 
William W Powell 



Richard Preston 

Richard Prouty 

Norman S. Rabb 

Ephraim Radner 

William G. Rosenberg 

Henry E. Russell 

John Ryan 

Roger A Saunders 

Roger D. Scoville 

Serge Semenenko 

William Shallow 

George Shapiro 

Mrs. George Sherman 

Stanley Shmishkiss 

Mrs. Robert W. Sides 

Edwin N. Sidman 

Samuel L. Slosberg 

Richard M. Smith, MD 

Sam Smith 

Mrs. Bernard Solomon 

Mrs. Charles E. Spencer, Jr. 

John K. Spring 

Geoffrey R. Stanwood 

Mrs. Bennett H. Stayman 

Richard C. Steele 

Mrs. Herman M. Stein 

S. Sidney Stoneman 

Frank J. Sulloway 

M. Greely Summers 

Douglas MacN. Surgenor, PhD 

Stephen B. Swensrud 

Humphrey H. Swift 

William N. Swift 

Mrs. John B. Tew 

Mrs. Sherman R. Thayer 

Lamont L Thompson 

Mrs. Herbert S. Tuckerman 

Jeptha H. Wade 

Charles R Waite 

Mrs. Jacob Wallace 

Mrs. Kenneth W Warren 

Edward A. Weeks, Jr. 

David S. Weiner 

Richard S. West 

Alexander Wheeler, Jr. 

Mrs. Henry Wheeler, Jr. 

James G. Wheeler 

Loren C. White, Sr. 

Howard S. Whiteside 

Ben Ames Williams, Jr. 

J. Robert Willing 

John J. Wilson 

Mrs. Raymond Wing 

William W. Wolbach 

Mrs. Samuel H. Wolcott, Jr. 

Richard M. Wyman 



25 



26 




Staff Directory 

(as of July 1,1977) 



Department of 
Medicine 



Physician-in- Chief 
Mary Ellen Avery, MD 
General Medicine 
Assistant to 
Physician-in-Chief 
Jonathan R. Bates, MD 

Senior Associates in Medicine 
William Berenberg, MD 
Anthony D. Bower, MD 
T Berry Brazelton, MD 
William D. Cochran, MD 
Harvey R. Colten, MD 
Thomas E. Cone, MD 
John F Crigler, MD 
Allen C. Crocker, MD 
Leonard W Cronkhite, MD 
Donald Fyler, MD 
Park S. Gerald, MD 
Richard Grand, MD 
Warren E. Grupe, MD 
Robert J. Haggerty.MD 
Charles A. Janeway, MD 
Sherwin E. Kevy, MD 
George A. Lamb, MD 
Robert R Masland, MD 
Alexander S. Nadas, MD 
David G. Nathan, MD 
Julian L. Pearlman, MD 
Fred S. Rosen, MD 
Harry Shwachman, MD 
Denise Strieder, MD 
H. William Taeusch, Jr., MD 
Demetrius G. Traggis, MD 
John W G. Tuthill, MD 
William D. Winter, MD 

Associates in Medicine 
Thomas W Adams, MD 
Robert B. Berg, MD 
Jan Breslow, MD 
Albert Cohen, MD 
Mary Ann Cromer, MD 
Richard W. Dodds, MD 
William R. Dorsey, MD 
Ralph Earle, Jr., MD 
Richard I. Feinbloom, MD 
Peter Goldman, MD 
John W Graef, MD 
Elizabeth A. Gregory, MD 
Norman Jaffe, MD 
George W Kerr, MD 
Kon-Taik Khaw, MD 



Jerome O. Klein, MD 
Melvin D. Levine, MD 
Janice C. Levy, MD 
Richard R Lipman, MD 
Frederick H. Lovejoy, MD 
Alexander S. MacDonald, MD 
Frederick Mandell, MD 
Richard E. McKeage, MD 
H . Lester Medlinsky, MD 
Alan H. Nauss, MD 
Eli Newberger, MD 
Robertson Parkman, MD 
William Pfeffer, MD 
Howard J. Potter, MD 
Daniel Rectanus, MD 
Robert T Sceery, MD 
Samuel N. Sherry, MD 
George L. Siegel, MD 
Irving Silverman, MD 
Arnold L. Smith, MD 
N. Philip Strause, MD 
Robert H. Suskind, MD 
Irving Umansky, MD 
Martin K. White, MD 
Robert H. Wilkinson, MD 
Mary Ellen Wohl, MD 
John W. Wood, MD 

Assistants in Medicine 
Patricia C. Adams, MD 
Joel A. Bass, MD 
Jonathan R. Bates, MD 
Doris R. Bennett, MD 
Euan T Blanch, MD 
Margot Blank, MD 
Leonard Bram, MD 
David S. Brown, MD 
James R. Cox, MD 
Prakash V. Desai, MD 
S. Jeans Emans, MD 
Stephen M. Frawley, MD 
T David Gill, MD 
Edward S. Gross, MD 
Lawrence S. Gross, MD 
Gordon Harper, MD 
Nancy W Hendrie, MD 
Heide D. Horsley, MD 
Mary C Howell, MD 
Stanislawa Janowska, MD 
Lawrence B. Johnson, MD 
Stephen C. Joseph, MD 
Richard A. Katz, MD 
Howard S. King, MD 
Roselyn L. Kolodny, MD 
Juanita A. Lamar, MD 
Martin E. Leber, MD 
Robert M. Levenson, MD 



Rudolph L. Leibel, MD 
Sherry W H. Loo, MD 
David L. Maltz, MD 
Eugenia Marcus, MD 
Edward B. Marsh, MD 
David McCormick, MD 
Shirley A. McMahon, MD 
KishorAMehta, MD 
Alice Nauen, MD 
Robert J. Orme,MD 
Judith S. Palfrey, MD 
Veronica S. Petersen, MD 
Jules Rako, MD 
M. Lawrence Reiner, MD 
George L Robb, MD 
Michael J. Robinson, MD 
Sol Rockenmacher, MD 
Benjamin Sachs, MD 
(Wrentham School) 
Mary D. Scott, MD 
Leslie Silverstone, MD 
Myron Siner, MD 
Arnold R. Soslow, MD 
Luisa C. Stigol, MD 
George Storm, MD 
Judith F Strauss, MD 
Lloyd D.Tarlin, Jr., MD 
William R. VanArsdell, MD 
Robert Zimin, MD 

Research Associates in 

Medicine 

Milton Kotelchuck, PhD 

Clyde Zalut, PhD 

Clinical Assistants in Medicine 
Samuel Andonian, MD 
William B. Foley, MD 
Mark Friedman, MD 

(Ambulatory) 
Raymond A. Kahn, MD 
Manorama Mathur, MD 
Edgar Y. Oppenheimer, MD 
Suzanne G. Riggs, MD 

(Adolescent) 
Daniel W Rosenn, MD 
Diane J. Schweitzer, MD 

Division of Adolescent and 
Young Adult Medicine 

Chief 

Robert R Masland, Jr., MD 

Associate Chief 

S. Jean Emans, MD 

Senior Associate in Medicine 

Charles S. Gleason, MD 

Assistants in Medicine 

Estherann M. Grace, MD 27 



Barbara L. O'Pray, MD 

David C. Osier, MD 

Lea B. Rabinowitz, MD 

Jay Sosenko, MD 

Norman R Spack, MD 

Division of Ambulatory 

Services 

Chief 

Melvin D. Levine, MD 

Senior Associate 

Robert J. Haggerty, MD 

Assistants in Medicine 

Lawrence B. Johnson, MD 

Jack R Shonkoff, MD 

Patricio Vives, MD 

Michael L. Weitzman, MD 

Program in Community Health 

Chief 

Melvin D. Levine, MD 

Associate Chief 

Judith S. Palfrey, MD 

Assistant in Medicine 

Gloria A. Rudish,MD 

Program in Comprehensive 

Child Care 

Acting Chief 

Lawrence B. Johnson, MD 

Associate in Medicine 

Janice C. Levy, MD 

Assistants in Medicine 

Donald M. Berwick, MD 

Howard R. Spivak, MD 

Patricio Vives, MD 

Martha M. Eliot Family Health 

Center 

Chief Pediatrician 
Susana C. Alvarez, MD 
Assistants in Medicine 
Marco Danon, MD 
Lynn Wallace.MD 

Special Medical Divisions 

Division of Allergy 

Chief 

RaifS. Geha,MD 
Associates in Allergy 
Irving W. Bailit, MD 
Theodore Bennett, MD 
Frank S. Twarog, MD 
Assistants in Allergy 
Robert Gedachian, MD 
Elizabeth M. Gregory, MD 
Lawrence S. Morse, MD 



Catherine L. O'Brien, MD 

Frank J. Piccone, MD 

Albert L. Sheffer, MD 

Division of Child Development 

Chief 

T Berry Brazelton, MD 

Associate in Medicine 

Eli H. Newberger, MD 

Assistants in Medicine 

Constance H. Keefer, MD 

Michael W. Yogman, MD 

Research Associates 

Heidelise R. Als, PhD 

Jessica Henderson Daniel, PhD 

Barry Lester, PhD 

Robert Reed, PhD 

Division of Clinical Genetics 

Chief 

Park S. Gerald, MD 

Senior Associate in Clinical 

Genetics 

Thomas E. Cone, Jr., MD 

Assistants in Clinical Genetics 

Samuel A. Latt, MD, PhD 

Rosamond R Murdock, MD 

Research Associates 

Gail Bruns, MD, PhD 

Richard L. Davidson, PhD 

A. James Epstein, PhD 

Division of Clinical 

Pharmacology 

Chief 

Peter Goldman, MD 

Associates in Clinical 

Pharmacology 

Paul A. Friedman, MD 

Frederick H. Lovejoy, MD 

Assistant in Clinical 

Pharmacology 

Allen A. Mitchell, MD 

Division of Cystic Fibrosis 

Chief 

Harvey R. Colten, MD 

Associates in Cystic Fibrosis 

Helen M. Caldicott, MD 

Kon-Taik Khaw, MD 

M. Lawrence Reiner, MD 

Assistants in Cystic Fibrosis 

Paul Edelson, MD 

Maria Kowalski, MD 

Research Associate in Cystic 

Fibrosis 

Abbas Mahmoodian, PhD 



Division of Dermatology 

Acting Chief 

Harley A. Haynes, MD 

Associate Chief 

Kenneth A. Arndt, MD 

Senior Associate in 

Dermatology 

Robert Griesemer, MD 

Associate in Dermatology 

Howard R Baden, MD 

Assistants in Dermatology 

Terry R Hadley, MD 

Gerald Merrill Liteplo, MD 

Samuel Moschella, MD 

Michael M. Pugliese, MD 

Nicholas A. Soter, MD 

Robert S. Stern, MD 

Bruce (J. Wintroub, MD 

Division of Endocrinology 

Chief 

John F Crigler, Jr., MD 

Associates in Endocrinology 

Kenneth H. Gabbay, MD 

Dorothy B. Villee, MD 

Research Associates in 

Endocrinology 

Beverly H. Bergstrom, PhD 

Norman I. Gold, PhD 

Division of Gastroenterology 

Chief 

Richard J. Grand, MD 

Associate in Gastroenterology 

John B. Watkins, MD 

Assistant in Gastroenterology 

Aubrey J. Katz.MD 

Program in Nutrition 

Coordinator 

Robert M. Suskind, MD 

Division of Hematology and 

Oncology 

Chief 

David G. Nathan, MD 

Senior Associates in Medicine 
Chester A. Alper, MD 
Emil Frei 111, MD 
Norman Jaffe, MD 

Associates in Medicine 
Herbert T Abelson, MD 
Blanche R Alter, MD 
Harvey J. Cohen, MD 
Robert Handin.MD 
Sherwin V. Kevy, MD 
Samuel E. Lux, MD 



Ronald R McCaffrey, MD 

Stephen E. Sallan, MD 

Charles D. Scher, MD 

Arthur Sytkowski, MD 

Ronald Yankee, MD 

Assistants in Medicine 

MitsukoTLaforet,MD 

Richard D. Propper, MD 

Joel M. Rappeport, MD 

Howard J. Weinstein, MD 

Research Associates in 

Medicine 

Larry Button, BS 

Diane G. Hillman, PhD 

Frederick R Li, MD 

Consulting Scientists in 

Medicine (Hematology and 

Oncology) 

David G. Baltimore, PhD 

Harvey F Lodish, PhD 

Division of Immunology 

Chief 

Fred S. Rosen, MD 

Senior Associates in 
Immunology 
Harvey R. Colten, MD 
Charles A. Janeway, MD 

Associates in Immunology 
Yves R. Borel, MD 
Robertson Parkman, MD 

Assistant in Immunology 
RaifS. Geha,MD 

Research Associates in 
Immunology 
David H.L Bing, PhD 
Halina Borel, MD 
Ezio Merler, PhD 

Visiting Research Associate in 

Immunology 

David K. Boraker, PhD 

Clinical Rheumatology 

Service 

Director 

Yves R. Borel, MD 

Division of Infectious Diseases 

Acting Chief 
Fred S. Rosen, MD 

Associates in Infectious 

Diseases 

Clyde Crumpacker, MD 

Jerome O. Klein, MD 

George R. Siber, MD 

Arnold L Smith, MD 



Assistants in Infectious 

Diseases 

Donald Goldmann, MD 

Myron Levin, MD 

Research Associate in 

Infectious Diseases 

Vassiliki Syriopoulou, MD 

Division of Metabolism 

Chief 

Jan L. Breslow, MD 
Research Associate 
A. James Epstein, PhD 

Division of Nephrology 

Chief 

Warren E. Grupe, MD 
Associates in Medicine 
John R. Hoyer, MD 
Julie R. Ingelfinger, MD 
John M. Lazarus, MD 

Director, 

Dialysis Unit 

Division of Newborn 
Medicine 

Chief 

H. William Taeusch, Jr., MD 

Associate Chiefs 
William Cochran, MD 
Ivan Frantz 111, MD 
Associates in Newborn 
Medicine 

John R Cloherty, MD 
John R Hubbell, MD 
Donald E. Muirhead, MD 
E. Manning Sears, MD 
John Watkins, MD 

Assistants in Newborn 

Medicine 

Elizabeth Brown, MD 

Michael F Epstein, MD 

Edward Lawson, MD 

Ann R. Stark, MD 

Research Associate in 
Newborn Medicine 
John S. Torday, PhD 

Division of Respiratory 
Diseases 

Chief 

Denise Strieder, MD 

Associate 

Mary Ellen Wohl,MD 

Research Associate 
Andrew Jackson, PhD 



Division of Services to 
Handicapped Children 

Cerebral Palsy 

Chief 

William Berenberg, MD 

Associate in Medicine 

Frederick Mandell, MD 

Mental Retardation and 

Developmental Disabilities 

Director 

Allen C. Crocker, MD 

.Associate Director 

Bruce Cushna, PhD 

Assistant in Medicine 

Margaret Siber, MD 

Director of Psychiatry 

Ludwik Szymanski, MD 

Director of Dentistry 

F Edward Gallagher, DMD 

Director of Physiology 

Richard R. Schnell, PhD 

Director of Special 

Education 

Jean M. Zadig, PhD 

Director of Rehabilitation 

William E. Kiernan, PhD 

Director of Speech Pathology 

&Audiology 

Martin C. Schultz, PhD 

Department of 
Anesthesiology 

Chief 

Robert M. Smith, MD 

Senior Associate in 

Anesthesia 

Dean Crocker, MD 

Associate in Anesthesia 

Carol H. Johnson, DDS 

Assistants in Anesthesia 

Dolly D. Hansen, MD 

Babu Koka, MD 

K.G. Sudhir, MD 

Department of 
Cardiology 

Chief 

Alexander S. Nadas, MD 
Associate Chief 
Donald C Fyler, MD 



Senior Associates in 
Cardiology 
R. Curtis Ellison, MD 
Michael D. Freed, MD 
Walter J. Gamble, MD 
John F Keane, MD 
C. Grant LaFarge, MD 
Amnon Rosenthal, MD 

(to 9/1/77) 
Roberta G. Williams, MD 
Associates in Cardiology 
Lucy R Buckley, MD 
Albert Cohen, MD 
MacdonaldDickIl,MD 

(toll/1/77) 
Kenneth E. Fellows, MD 
Allan Goldblatt, MD 
Laurence J. Sloss, MD 
Stella Van Praagh, MD 
Stephen Vatner, MD 
Assistants in Cardiology 
Robert A Dye, MD 
Amy Edalji, MD 
Gordon R Harper, MD 
Mary Jane Luke, MD 
David L. Maltz, MD 
Marlene Rabinovitch, MD 
Research Associates in 
Cardiology 
Olli S. Miettinen, MD, PhD 

(Epidemiology) 
Israel Mirsky, PhD 

(Biomathematics) 
Kenneth K. Rothman, DMD, 
Dr.PH 

(Epidemiology) 
Richard Van Praagh, MD 

(Pathology) 

Department of 
Cardiovascular Surgery 

Chief 

Aldo R. Castaneda, MD 
Senior Associates in Cardio- 
vascular Surgery 
William F Bemhard, MD 
Nina S. Braunwald, MD 
Associates in Cardiovascular 
Surgery 

Lawrence H. Cohn, MD 
John J. Collins, MD 
George WB. Starkey, MD 
Assistant in Cardiovascular 
Surgery 
William 1. Norwood, MD 



Department of 
Dentistry 



Chief 

J. Anthony Hargreaves, MChD 
Senior Associates in 
Pedodontics 
M. Michael Cohen, DMD 
Norman T. Budde, DMD 
Howard L Needleman, DMD 
Stephen Shusterman, DMD 
Senior Associates in 
Orthodontics 
Melvin 1. Cohen, DMD 
Peter K.J. Yen, DMD 
Senior Associate in Oral 
Surgery 

Walter C. Guralnick, DMD 
Associates in Pedodontics 
John D. Doykos III, DMD 
Carl G. Cohen, DMD 
Terrence D. Hoover, DMD 
Associate in Orthodontics 
Stephen S. Hilzen'rath, DMD 
Associate in Oral Surgery 
Leonard B. Kaban, DMD, MD 
Assistants in Pedodontics 
F Edward Gallagher, DMD 
Norman Goldberg, DMD 
Jack Hertzberg, DMD 
George Kates, DMD 
Assistant in Oral Surgery 
Earle H. Rosenberg, DMD 
Assistant in Periodontics 
Noah Zager, DMD 
Assistant in Prosthetics 
Robert Burr, DMD 
Clinical Assistants in 
Pedodontics 
Michael Coppe, DMD 
Burton Edelstein, DMD 
Sam Eisenstein, DMD 
Bruce Fieldman, DMD 
Robert A. Frank, DMD 
Steven D. Lasser, DMD 
Eli Schneider, DMD 
Lawrence M. Rubin, DMD 
Robert F Watton, DMD 



2! 



Department of 
Neurology 



Chief 

Charles F Barlow, MD 
Senior Associate in Neurology 
Cesare T Lombroso, MD 
Associates in Neurology 
Michael J. Bresnan, MD 
Martha B. Denckla, MD 
Frank H. Duffy, MD 
Giuseppe Erba, MD 
Alan Leviton, MD 
Hubert S.Mickel.MD 
S. Robert Snodgrass, MD 
Liza Yessayan, MD 
Assistants in Neurology 
Norberto Alvarez, MD 
Thomas E. Browne, MD 
Paul N. Chervin, MD 
Marc Dichter, MD 
Michael S. Duchowny, MD 
H. Harris Funkenstein, MD 
James G.T Nealis, MD 
Dennis Selkoe, MD 
Stephen M. Sergay, MD 

Learning Disabilities Unit 

Director 

Martha Bridge Denckla, MD 
Coordinator of Educational 
Screening Program 
Christopher Connolly, PhD 
Reading and Learning 
Disabilities Specialist 
Margaret Isabel Guild, EdD 

Division of Neurophysiology 
and Seizure Unit 

Chief 

Cesare T Lombroso, MD 

Associates 

Frank H. Duffy, MD 

Giuseppe Erba, MD 

Assistants 

Albert A. Ackil, MD 

James G.T Nealis, MD 

Director of Special Procedures 

Yoichi Matsumiya, PhD 

Research Associates, Seizure 

Unit 

Barbara A. Balaschak, MA 

Valerie C. Erba, PhD 

Harold Goodglass, PhD 



Mildred J. Mclntyre, PhD 
David 1. Mostofsky, PhD 
Division of Neuroscience 
(Department of Neuroscience 
Mental Retardation Research 
Program) 
Chief 

Richard L Sidman, MD 
Senior Research Associates 
Antonio V. Lorenzo, PhD 
Pasko Rakic, MD, ScD 
Michael Shelanski, MD, PhD 
S. Robert Snodgrass, MD 
Research Associates 
James Burchfiel, PhD 
Frank Duffy, MD 
Louise L. Edds, PhD 
Thomas O. Fox, PhD 
Lloyd A. Greene, PhD 
Christo Goridis, MD 
Tessa Hedley-Whyte, MD 

(to 8/31/77) 
Elias Kouvelas, MD 
Anne Messer, PhD 
Richard J. Mullen, PhD 
Melitta Schachner, PhD 
Research Assistants 
Michael Biber, MD 
Janet C. Blanks, PhD 
Scott Brand, PhD 
Shu-Hui Chen-Yen, PhD 
Stanley Froehner, PhD 
Cecilia T Giambalvo, PhD 
Mary E. Hatten, PhD 
Karl Herrup, PhD 
Lawrence W. Kneisley, MD 
Virginia Lee, PhD 
Ronald Liem, PhD 
Jeffrey C. McGuire, PhD 
Yoshihiro Ogawa, MD 
CarlaJ.Shatz, PhD 
Jerry Silver, PhD 
Ana Sotrel, MD 
Suzanne Tarlov, PhD 
Ekkhart Trenkner, PhD 
Christine C. Vito, PhD 
Marian Willinger, PhD 
Visiting Research Associates 
Heinz Kunzle, MD 
Francois Rieger, PhD 
Research Associates 
(Neuroanatomy) 
Gary Van Hoesen, PhD 

(Neuroanatomy and 

Psychology) 



Deepak H. Pandya, MD 

(Neuroanatomy) 
Biochemist 
Paul M. Gallop, PhD 
Research Associates 
Laurence Bonar, AB 
Carlo DeLuca, PhD 
David Eyre, PhD 
Alan Grodzinsky, ScD 

(to 8/31/77) 
Peter Hauschka, PhD 
Marijke Holtrop, MD, PhD 
William J. Landis, PhD 
Harold M. Lipshitz, PhD 
Mercedes Paz, PhD 
Barry Reit, PhD 
Aziza H. Soliman-Fam, MD 
B. Marina Torrelio, PhD 
Clyde Zalut, PhD 
Research Assistants 
Carlotta Evans, DDS 
Edward Henson, BS 
David A. Keith, BDS 
Jane Lian, PhD 
Joseph Mansour, PhD 
Diane Brickley Parsons, PhD 
William K. Sabine, MS 
Masako Sakamoto, DDS, PhD 
Seizaburo Sakamoto, DDS, PhD 
Elsa Strawich, PhD 

Department of 
Neurosurgery 

Chief 

W.Keasley Welch, MD 
Senior Associate in 
Neurosurgery 
JohnShillito,Jr.,MD 
Associates in Neurosurgery 
Edwin G. Fischer, MD 
William G. Heisey, MD 
Francis X. Rockett, MD 
Ken R. Winston, MD 
Assistant in Neurosurgery 
John W Walsh, MD 

(to 8/1/77) 
Senior Research Associate 
Antonio Lorenzo, PhD 

Department of 
Ophthalmology 



Chief 

Richard M. Robb, MD 



Senior Associates in 
Ophthalmology 
Sumner D. Liebman, MD 
Robert A. Petersen, MD 
Associates in Ophthalmology 
William R Boger, MD 
Robert E. Quran, MD 
Anne B. Fulton, MD 
Assistants in Ophthalmology 
Ann M. Bajart, MD 
Robert A. Gorn.MD 
Research Assistant in 
Ophthalmology 
Jerry Silver, PhD 

Department of 
Orthopaedic Surgery 

Chief 

Melvin J. Glimcher, MD 

Clinical Chief 
John E. Hall, MD 
Senior Associates in Ortho- 
paedic Surgery 
Paul W. Hugenberger, MD 
Edward Nalebuff, MD 
Edward J. Riseborough, MD 
Richard Smith, MD 
Arthur WTrott.MD 
Associates in Orthopaedic 
Surgery 

Lyle J. Micheli, MD 
Eric L. Radin, MD 
Robert K. Rosenthal, MD 
Sandra J. Thomson, MD 
Hugh G. Watts, MD 
Junior Associates in Ortho- 
paedic Surgery 
Richard Scott, MD 
Barry Simmons, MD 
Assistants in Orthopaedic 
Surgery 

John Michael Allen, MB, BS 
John E. Kenzora, MD 
Frederic Shapiro, MD 
Sheldon R. Simon, MD 
Junior Assistants in Ortho- 
paedic Surgery 
Frederick Jones, MD 

(to 7/31/77) 
Scott Van Linder, MD 

(to 12/31/77) 
Visiting Assistants in Ortho- 
paedic Surgery 



Frank D. Bates, MD 
Benjamin E. Bierbaum, MD 
Thomas L DeLorme, MD 
Michael A. Drew, MD 
Hamish Gillies, MD 
J. Drennan Lowell, MD 
James G. Manson, MD 
Robert Runyon, MD 
Alan Schiller, MD 
William Shea, MD 
William M. Southmayd, MD 
Marvin Weinfeld, MD 

Department of 
Otolaryngology 

Chief 

Stuart Strong, MD 
Associate Chief 
Gerald B. Healy, MD 
Senior Associates in 
Otolaryngology 
Burton F. Jarfe, MD 
Marshall Strome, MD 
John Trakas, MD 
Charles W Vaughan, MD 
Associates in Otolaryngology 
Allan G. Edwards, Jr., MD 
Edward Glinski, MD 
Clarence E. Kylander, MD 
Trevor McGill, MD 
Assistants In Otolaryngology 
Marvin Fried, MD 
Edward E. Jacobs, MD 
Ely Kirschner, MD 
William G. Lavelle, MD 
Stanley Shapshay, MD 
Hearing and Speech Division 
Director 

Martin Schultz, PhD 
Senior Audiologist 
Martha B. Lyle, PhD 
Speech Pathologist 
Anthony S. Bashir, PhD 
Research Associates 
Louis D. Braida, PhD 
Nathaniel I. Durlach, BA 
James P. Fraser, PhD 
Speech Consultant 
Paula Menyuk, PhD 

Department of 
Pathology 



Chief 

Lynne Reid, MD 

Associate Chief 

Gordon F. Vawter, MD 

Pathologist 

Eveline E. Schneeberger, MD 

Assistant Pathologist 

Zebulon B. Vance, MD 

Cardiac Pathologist 

Richard Van Praagh, MD 

neuropathologists 

Floyd Gilles, MD 

Tessa Hedley-Whyte, MD 

(to 8/31/77) 
Ana Sotrel, MD 

Assistant neuropathologists 
R. Damon Averill, Jr., DVM 
Michael L. Shelanski, MD, PhD 

Research Associates in 

Pathology 

Krishna Bhaskar, PhD 

Stephen J. Coles, PhD 

George E. Foley, ScD 

Betty Jean Hargis, PhD 

Mervyn Israel, PhD 

Rosemary Jones, MPhil 

Awtar Krishan-Ganju, PhD 

Herbert Lazarus, PhD 

Marie-Teresa Lopez- Vidriero, MD 

Saul Malkiel, MD, PhD 

Barbara Meyrick, PhD 

Edward J. Modest, PhD 

Antonio M. Rendas, MD 

Andre Rosowsky, PhD 

Sisir Sengupta, PhD 

Henry Slayter, PhD 

Adrian Williams, MB, BS 

George Yerganian, PhD 

Research Assistant in 

Pathology 

T.S.AnathaSamy,PhD 

Director of Clinical 

Laboratories 

Joseph B. Alpers, MD, PhD 

Department of 
Psychiatry 

Acting Chief 
Donald J. Scherl,MD 

Senior Associates in Psychiatry 

Children's Hospital 
John R. Blitzer, MD 



William M. Crowell, MD 
Chester C. d'Autremont, MD 
Leon Eisenberg, MD 
Richard Galdston, MD 
Donald J. Scherl,MD 
Veronica B. Tisza, MD 
Peter H. Wolff, MD 
Norman E. Zinberg, MD 
Judge Baker Guidance 
Center 

John C. Coolidge, MD 
Joseph J. Mullen, MD 
Donald H. Russell, MD 
Stanley Walzer.MD 
Associates in Psychiatry 
Children's Hospital 
Myron Belfer, MD 
Herbert L Needleman, MD 
John E. O'Malley, MD 
Eugene U. Piazza, MD 
Alexandra K. Rolde, MD 
Nancy Rollins (Youse), MD 
Ludwik Szymanski, MD 
Judge Baker Guidance 
Center 

Ernest W.Bergel,MD 
Alice Fleming, MD 
Robert H. McCarter, MD 
Joan Zilbach, MD 
Assistants in Psychiatry 
Children's Hospital 
Graham B. Blaine, MD 

(Adolescent Medicine) 
David Brown, MD 
Harvey Budner, MD 
Theodore Dreier, MD 
J. Felton Earls, MD 
Bruce Eissner, MD (DEC) 
Gordon Harper, MD 
Alexandra Murray Harrison, MD 
Bruce Hauptman, MD 
James Herzog, MD 
Ralph G. Hirschowitz, MD 
Richard Pohl, MD 
Alan Prager, MD 
Paul A. Reising, MD 
Timothy Rivinus, MD 
Quinn B. Rosefsky, MD 
William B. Rothney, MD 
Henry F Smith, MD 
David Waller, MD 
Harold Wolman, MD 
Robert Ziegler, MD 
Robert Zimin, MD 
Judge Baker Guidance 



Center 

George Hardman, MD 
Donna M. Norris, MD 
Herschel Rosenzweig, MD 
Bayla Schorr, MD 
John L. Weil, MD 

Research Associates 

Children s Hospital 
Heidelise Als, PhD 
Mary L. Carlson, PhD 

(Psychology) 
Marjorie F Elias, EdD 

(Psychology) 
Richard A. Ferber, MD 
Rose E. Frisch, PhD 
Charles Gunnoe, EdD 
Annette Silbert, PhD 

(Psychology) 
Edward C. Tronick, PhD 

(Psychology) 
Deborah R Waber, PhD 

(Psychology) 
Marion 1. Walter, EdD 

Psychologists 

Children s Hospital 
Joseph R Lord, PhD, Chief 
Ruth S. Aisenberg, PhD 

(Cardiology) 
Harry Bakow, PhD 
Mary Patricia Boyle, PhD 
Haskel Cohen, PhD 
Bruce Cushna, PhD (MRCJ) 
Jessica H. Daniel, PhD 

(Family Development Study) 
Andrea Farkas, PhD (DEC) 
Richard Geist, EdD 
Harold Goodglass, PhD 

(Seizure Unit) 
Jane Mary Holmes, PhD 
Irving Hurwitz, PhD 
Betsy Kammerer, PhD 

(Hearing and Speech) (DEC) 
Gerald R Koocher, PhD 
Alice K. Locicero, PhD 
Ann D. Salomon, PhD 
Richard Schnell, PhD (MRU) 
Theoheris Seghom, PhD 

(Seizure Unit) 
Natalie D. Sollee, PhD 
Albert Trieschman, PhD 
Charles B. Woodbury, PhD 
Karen Zelan, PhD 
Judge Baker Guidance 
Center 
Bessie Sperry, PhD, Chief 



3) 



Thelma Alper, PhD 
Ellen Berger, PhD 
Pauline Hahn, PhD 
William Hudgins, PhD 
Hugh Leichtman, PhD 
Martin Norman, PhD 
Phoebe Schnitzer, PhD 
Robert Selman, PhD 
William Shumate, PhD 

Department of 
Radiation Therapy 

Chief 

Samuel Hellman, MD 

Associates in 
Radiation Therapy 
James A. Belli, MD 
William D. Bloomer, MD 
Leslie E. Botnick, MD 
J. Robert Cassady, MD 
John T Chaffey, MD 
Philip Cole, MD 

(Epidemiology) 
Robert L. Goodman, MD 

(to 8/1/77) 
Joel S. Greenberger, MD 
Jay R. Harris, MD 
Martin B. Levene, MD 
Abraham Marck, MD 
Ralph Weichselbaum, MD 
Director, Division of 
Radiation Physics 
Bengt Erik Bjarngard, DSc 

Department of 
Radiology 

Chief 

John A. Kirkpatrick, MD 

Associate Chief 

G.B. Clifton Harris, MD 

Radiologists 

William J.H. Caldicott, MB, BS 

Kenneth E. Fellows, MD 

N. Thome Griscom, MD 

Robert L. Lebowitz, MD 

Roy D. Strand, MD 

Rita L. Teele, MD 

Robert H. Wilkinson, MD 

Senior Consultant 

in Radiology 

Edward B.D. Neuhauser, MD 

Visiting Neuroradiologist 

Richard A. Baker, MD 



Division of Nuclear Medicine 

Chief of Nuclear 
Medicine Service 
S. James Adelstein, MD 
Chief of Pediatric Nuclear 
Medicine 

Salvador Treves, MD 
Radiologists 
David E. Drum, MD 
B. Leonard Holman, MD 
Associate Radiologists 
William D. Kaplan, MD 
Barbara J. McNeil, MD 
Radiopharmaceutical 
Chemist 

Michael A. Davis, ScD 
Associate Radiopharma- 
ceutical Chemist 
Alun G.Jones, PhD 

Department of Surgery 

Surgeon-in-Chief 
Judah Folkman, MD 
Associate Chief of Surgery 
Samuel R. Schuster, MD 
Senior Associates in Surgery 
Arnold H. Colodny, MD 

(and Urology) 
John H. Fisher, MD 
Donald W MacCollum, MD 
Joseph E. Murray, MD 

(Plastic Surgery) 
Associates in Surgery 
Thomas W. Botsford, MD 
Chilton Crane, MD 
Angelo J. Eraklis, MD 
George H. Gifford, MD 

(Plastic Surgery) 
Donald R Goldstein, MD 

(Gynecology) 
Leonard B. Kaban, MD, DMD 

(Oral Surgery) 
John Leventhal, MD 

(Gynecology) 
Raphael H. Levey, MD 
Alan B. Retik, MD 

(Urology) 
Kenneth J. Welch, MD 
Assistants in Surgery 
Stuart B. Bauer, MD 

(Urology) 
Thomas C. Cochran, Jr. MD 
Paul R. Goldstein, MD 

(Gynecology) 



Robert M. Goldwyn, MD 

(Plastic Surgery) 
Julius Lister, MD 
Kenneth A. Marshall, MD 
John B. Mulliken, MD 

(Plastic Surgery) 
Charles D. Smith, III, MD 
Francis G. Wolfort, MD 

(Plastic Surgery) 
Joseph Upton, MD 

(Plastic Surgery) 
Research Associates 
in Surgery 

Dianna Ausprunk, PhD 
Christian K. Haudenschild, MD 
Hyman Hartman, PhD 
Michael Klagsbrun, PhD 
Robert Langer, ScD 
Clinical Assistants in Surgery 
Robert D. Blute, MD 
Charles Elboim, MD 
Stephen F Hansen, MD 
Mark N. Goldstein, MD 
Stephen J. Upson, MD 
Vladimir RShurlan.MD 
William B. Waters, MD 
Division of Gynecology 
Chief 

Donald R Goldstein, MD 
Division of Plastic Surgery 
Chief 

Joseph E. Murray, MD 
Division of Urology 
Chief 
Alan B. Retik, MD 

Consultants 

Walter H. Abelmann, MD 

Cardiology 

Herbert L. Abrams, MD 

Radiology 

Raymond D. Adams, MD 

Neurology 

Henry F Allen, MD 

Ophthalmology 

JoelJ.Alpert,MD 

Medicine 

Harold Amos, PhD 

Microbiology 

K. Frank Austen, MD 

Medicine 

Paul Axelrod, MD 

Cardiology 



C. Cabell Bailey, MD 
Medicine 

Henry Banks, MD 
Orthopaedic Surgery 
A. Clifford Barger, MD 
Physiology 

Virginia A Beal,MPH 
Nutrition 

Baruj Benacerraf, MD 

Pathology 

Don C. Bienfang, MD 

Ophthalmology 

Elkan Blout, PhD 

Chemistry 

Eugene Braunwald, MD 

Cardiology 

Hathorn R Brown, MD 

Urology 

Randolph K. Byers, MD 

Neurology 

Louis Caplan, MD 

Neurology 

Leo T Chylack, Jr., MD 
Ophthalmology 
Jonathan Cohen, MD 
Orthopaedic Surgery 
and Pathology 
Ramzi Cotran, MD 
Pathology 

Joseph G. Cutler, MD 
Cardiology 

John M. Craig, MD 

Pathology 

Edward Daniels, MD 

Psychiatry 

Bernard D. Davis, MD 

Microbiology 

David M. Dawson, MD 

Neurology 

Lewis Dexter, MD 

Cardiology 

Claes H. Dohlman, MD 

Ophthalmology 

John R. Eichorn, EdD 

Special Education 

Kendall Emerson, MD 

Medicine 

John Enders, PhD 

Virus Research 

Don W. Fawcett, MD 

Anatomy 




33 



David S. Feingold, MD 

Infectious Diseases 

Benjamin G. Ferris, MD 

Environmental Health 

Abraham Fineman, MD 

Psychiatry 

Thomas B. Fitzpatrick, MD 

Dermatology 

David G. Freiman, MD 

Pathology 

Allan L. Friedlich, MD 

Cardiology 

Nancy Gaspard, PhD 

Nursing 

Sydney S. Gellis,MD 

Medicine 

Norman Geschwind, MD 

Neurology 

Horace M. Gezon, MD 

Medicine 

Luke Gillespie, MD 

Obstetrics 

Irving H. Goldberg, MD 

Pharmacology 

Harvey Goldman, MD 

Pathology 

W. Morton Grant, MD 

Ophthalmology 

William T Green, MD 

Orthopaedic Surgery 

Alan J. Grodzinsky, ScD 

(9/1/77) 
Bioengineering 
Constantine L. Hampers, MD 
Medicine 

Herbert I. Harris, MD 
Psychiatry 

J. Hartwell Harrison, MD 
Urology 

Anne Henderson, PhD 
Occupational Therapy 
Howard H. Hiatt, MD 
Medicine 

Helen K. Hickey, MEd 
Physical Therapy 
David E. Housman, PhD 
Biology 

Howard Jacobson, MD 
Obstetrics 

Andrew Jessiman, MD 
Family Medicine 



Robert CI. Johnson, BS 

Radiation Safety 

Michael L. Kaplan, DVM 

Toxicology, Radiopharmacy 

Manfred Karnovsky, PhD 

Biochemistry 

Morris J. Karnovsky, MBBCh 

Pathology 

Edward Kass, MD 

Infectious Diseases 

Eugene P. Kennedy, PhD 

Biochemistry 

Sidney Kibrick, MD 

Infectious Diseases 

Edmund Klein, MD 

Pathology 

Charles J. Klim, PhD 

Speech Pathology 

andAudiology 

Stephen W. Kuffler, MD 

Neurophysiology 

Deborah R.R Langston, MD 

Ophthalmology 

Merle Legg, MD 

Pathology 

Bernard Lown, MD 

Cardiology 

HenryJ.Mankin, MD 

Orthopaedic Surgery 

Leonard C. Marcus, MD 

Infectious Diseases 

Harold May, MD 

Family Medicine 

Jean Mayer, PhD, DSc 

Nutrition 

Robert T McCluskey, MD 

Pathology 

William V. McDermott, MD 

Surgery 

William Meissner, MD 

Pathology 

Karl S. Menger, PhD 

Applied Mathematics 

John P. Merrill, MD 

Medicine 

Martin C. Mihm, MD 

Pathology 

David Miller, MD 

Ophthalmology 

William Moloney, MD 

Medicine 



William W. Montgomery, MD 

Otolaryngology 

Francis D. Moore, MD 

Surgery 

Van C. Mow, PhD 

Biophysics 

Martin L Norton, MD 

Anesthesia 

Igor T.Paul, ScD 

Bioengineering 

Peter L. Pellett, PhD 

Nutrition 

Abijah Pierce, DMD 

Orthodontics 

W. Warren Point, MD 

Medicine 

Theodore A. Potter, MD 

Orthopaedic Surgery 

Cathie S. Ragovin, MD 

Psychiatry (Adolescent 

Medicine) 

Raymond J. Reilly, MD 

Gynecology 

Robert G. Rosenberg, MD 

Community Medicine 

Alain B. Rossier, MD 

Neurosurgery & 

Orthopaedic Surgery 

Kenneth Ryan, MD 

Obstetrics and Gynecology 

Ferdinand Salzman, MD 

Radiation Therapy 

Arthur A Sasahara, MD 

Cardiology 

Albert Schilling, MD 

Medicine 

Harold Schuknecht, MD 

Otolaryngology 

Rose E. Segal, DSW 

Social Work 

Jacob Shapiro, PhD 

Radiation Safety 

Gerald Shklar, DDS 

Oral Pathology 

William Silen, MD 

Surgery 

Clement B. Sledge, MD 

Orthopaedic Surgery 

Ivor Smith, MD 

Anesthesia 

Thomas Smith, MD 

Cardiology 



Arthur Solomon, MD 

Nuclear Medicine 

George P. Sturgis, MD 

Medicine 

Paul H. Sugarbaker, MD 

Surgery 

Nathan B. Talbot, MD 

Medicine 

Marvin K. Tanzer, MD 

Biochemistry 

Melvin L. Taymor, MD 

Gynecology 

Charles Trey, MB, ChB 

Medicine 

Clara F Tubby, BS 

Consumer Education 

H.Richard Tyler, MD 

Neurology 

Carl W Walter, MD 

Surgery 

David S. Walton, MD 

Ophthalmology 

Richard Warren, MD 

Surgery 

Eric T Weber, MD 

Radiation Therapy 

John D.Webster, PhD 

Special Education 

Louis Weinstein, MD 

Infectious Diseases 

Thomas H. Weller, MD 

Parasitic and Viral Diseases 

James L. Whittenberger, MD 

Physiology 

Merrill K. Wolf, MD 

Neuroscience 

Richard Wolff, MD 

Cardiology 

Dorothy Worth, MD 

Maternal and Child Health 

Clement Yahia.MD 

Gynecology 

Alfred Yankauer, MD 

Orthopaedic Surgery 

Nicholas T Zervas, MD 

Neurosurgery 

Seymour Zimbler, MD 

Orthopaedic Surgery 

Paul M. Zoll, MD 

Cardiology 

James Zuckerman, MD 

Obstetrics 



Emeriti 



Donald L. Augustine, MD 

Comparative Pathologist, 

Emeritus 

Theodore L. Badger, MD 

Consultant in Medicine, 

Emeritus 

James M. Baty, MD 

Consultant in Medicine, 

Emeritus 

"Fully Benaron, MD 

Senior Associate in Psychiatry, 

Emeritus 

Edward F Bland, MD 

Consultant in Medicine, 

Emeritus 

Albert H. Brewster, MD 

Orthopaedic Surgeon, 

Emeritus 

John H. Brines, MD 

Associate in Medicine, 

Emeritus 

Allan M. Butler, MD 

Consultant in Medicine, 

Emeritus 

Randolph K. Byers, MD 

Neurologist-in-Chief Emeritus 

Hans I Clarke, PhD 

Consultant in Chemistry, 

Emeritus 

Stewart H. Clifford, MD 

Senior Associate in Medicine, 

Emeritus 

David G. Cogan, MD 

Consultant in Ophthalmology, 

Emeritus 

Joseph G. Cutler, MD 

Associate in Cardiology, 

Emeritus 

Gabor Czoniczer, MD 

Research Associate in 

Rheumatic Fever Research, 

Emeritus 

Gustave J. Dammin, MD 

Consultant in Pathology, 

Emeritus 

John A.V. Davies, MD 

Senior Associate in Medicine, 

Emeritus 



Louis K. Diamond, MD 
Associate Physician-in-Chief, 
Senior Associate in Medicine 
and Chief of Hematology Divi- 
sion, Emeritus 
Edwin B. Dunphy, MD 
Consultant in Ophthalmology, 
Emeritus 

Martha M. Eliot, MD 
Consultant in Child Health, 

EmeritUS (deceased February 14, 1978) 

John Enders, PhD 

Chief of Virus Research Unit, 

Emeritus 

Charles F Ferguson, MD 

Senior Associate in 

Otolaryngology, Emeritus 

Carlyle G. Rake, MD 

Otolaryngologist-in-Chief, 

Emeritus 

Henry M. Fox, MD 

Consultant in Child Health, 

Emeritus 

Albert A. Frank, MD 

Senior Associate in Medicine, 

Emeritus- 

J. Roswell Gallagher, MD 

Chief, Adolescents' Unit, 

Emeritus 

Henry Gallup, MD 

Senior Associate in Medicine, 

Emeritus 

George E. Gardner, MD, PhD 

Psychiatrist-in-Chief, Emeritus 

William T Green, MD 

Orthopaedic Surgeon-in- 

Chief, Emeritus 

Robert E. Gross, MD 

Cardiovascular Surgeon-in- 

Chief, Emeritus 

Trygve Gundersen, MD 

Ophthalmologist-in-Chief 

Emeritus 

Herbert I. Harris, MD 

Associate in Psychiatry, 

Emeritus 

Eliot Hubbard, Jr., MD 

Physician, Emeritus 

Henry W. Hudson, MD 

Consultant in Surgery, 

Emeritus 



Charles A. Janeway, MD 

Physician-in-Chief, Emeritus 

Otto Krayer, MD 

Consultant in Pharmacology, 

Emeritus 

Eugene M. Landis, MD 

Consultant in Physiology, 

Emeritus 

Paul K. Losch, DDS 

Dentist-in-Chief Emeritus 

Benedict Massell, MD 

Chief, Rheumatic Fever 

Research Unit, Emeritus 

Dorothea May Moore, MD 

Associate in Medicine, 

Emeritus 

Harry L. Mueller, MD 

Chief, Allergy Division, 

Emeritus 

Edward B.D. Neuhauser, MD 

Radiologist-in-Chief, Emeritus 

Marion W. Ropes, MD 

Consultant in Medicine, 

Emeritus 

Gertrud C. Reyersbach, MD 

Associate in Medicine, 

Emeritus 

David D. Rutstein, MD 

Senior Associate in Medicine, 

Emeritus 

Harold I. Shuman, MD 

Associate in Medicine, 

Emeritus 

Harry Shwachman, MD 

Chief of the Division of 

Clinical Nutrition, Emeritus 

Edward I. Silver, DMD 

Associate in Orthodontics, 

Emeritus 

Abraham S. Small, MD 

Consultant in Medicine and 

Associate in Medicine, 

Emeritus 

Magnus Smedal, MD 

Consultant in Radiology, 

Emeritus 

Clement A. Smith, MD 

Senior Associate in Medicine, 

Emeritus 

Richard M. Smith, MD 

Physician-in-Chief, Emeritus 



Harold C. Stuart, MD 

Consultant in Child Health, 

Emeritus 

Somers H. Sturgis, MD 

Consultant in Gynecology, 

Emeritus 

George W. Thorn, MD 

Consultant in Medicine, 

Emeritus 

Jacob Wallace, MD 

Associate in Cardiology, 

Emeritus 

Geraldine Rickard Weil, EdD 

Psychologist, Emeritus 

Edwin T Wyman, MD 

Physician, Emeritus 

Paul Yakovlev, MD 

Consultant in neuropathology, 

Emeritus 



35 



36 





The Children's Hospital Medical Center 

300 Longwood Avenue, Boston. Massachusetts 02115